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Verapamil and beta-blocker — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsVerapamil and beta-blockerGPhC CRA

A 73-year-old woman with atrial fibrillation takes bisoprolol 5mg daily. A prescription for verapamil modified-release 240mg daily is presented for rate control. Her pulse is 58 beats/min and she reports dizziness. What is the most important interaction to flag?

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Correct answer: A — Verapamil with a beta-blocker can cause bradycardia and heart block

Verapamil and beta-blockers both slow AV conduction and can cause bradycardia, hypotension and heart block when combined. The patient already has a low pulse and dizziness, increasing the need for urgent review. The prescription should be queried before supply.

Reference: BNF